Key Opinion Leading Surgeons Publish a Simple, Standardized Technique for Laparo-Endoscopic Single Site (LESS) Cholecystectomy in the Prestigious Journal of Surgical Endoscopy

LESS Surgery Through a Small Incision at The Bellybutton is Now a Practical Reality for All Surgeons

TAMPA, Fla.--(BUSINESS WIRE)--A white paper written by leading surgeons in the United States, Europe, and Asia on the Standardization of LESS Cholecystectomy (the surgical removal of a gallbladder) has just been published in the Surgical Endoscopy. Gallbladder removal is one of the most common abdominal surgical procedures in the world. It is usually undertaken by making four incisions in the abdominal wall into which individual ports and instruments are inserted. Each incision can cause scarring, pain, bleeding, infection, and a hernia. In an effort to minimize these potential complications, surgeons have been working to place all four instruments through a single incision made in the belly-button, over an already existing scar. Today, by offering a standardized approach to LESS cholecystectomy, a significant milestone has been achieved to revolutionize modern surgery.

“Surgeons who use this technique or wish to consider using it in the future will benefit from having a clear set of guidelines. This surgical approach certainly improves the safety and reproducibility of single incision laparoscopic cholecystectomy.”

The concept of using a multi-instrument technique through a single small bellybutton (umbilical) incision was first published in 2007. Since then, surgeons in the United States, Europe, and Asia have collectively published more than one thousand articles demonstrating the feasibility and benefits of LESS surgery, with particular focus on General Surgery, Gynecology and Urology specialties. There has been a surge in the numbers of presentations at surgical conferences, in newspapers and on local news channels. Many surgical companies have risen to the challenge and developed tools to assist in undertaking LESS operations. This spans the gamut from access ports, to specialized visualization laparoscopes, and even expanded the use of surgical robots. While individual surgical centers have proposed and published feasible methods to undertaking certain operations, the major roadblock to universal adoption has been the lack of a uniform approach to any specific surgical procedure. Although a myriad of approaches have merit, none offer across the board benefits, including; ease of operation, small incision to completely hide the post-operative scar, lower cost of undertaking the operation, and similar time taken to complete single-incision versus the traditional multi-incision approach, this standardization ensures that every laparoscopic surgeon can safely offer this minimally invasive operation and add it to their surgical armamentarium.

In response to this need, leaders of Minimally Invasive Surgery from the United States, Europe and Asia have joined forces in a consortium for LESS cholecystectomy to develop a consensus statement for this operation through a single 1.2 - 1.5 cm incision at the umbilicus. This diverse group of surgeons represents many different fields of expertise, from prestigious academic institutions to community hospitals, and overseas locations in Europe and Asia. Dr. Sharona Ross (Florida Hospital Tampa), who was a key figure in bringing this assembly together along with Dr. Alexander Rosemurgy (Florida Hospital Tampa), states that, “The group had a primary focus of offering a method which provides a safe, easily adoptable approach to single incision laparoscopic surgery, with reproducible outcomes.” Dr. Rosemurgy adds, “This method mimics the traditional four incision approach to cholecystectomy, but through an incision small enough to easily fit inside the bellybutton and leave no apparent scar.” Dr. Homero Rivas (Stanford University) comments, “This is a major breakthrough in gallbladder surgery.” Dr. Steve Schwaitzberg (Harvard University) further states: “Surgeons who use this technique or wish to consider using it in the future will benefit from having a clear set of guidelines. This surgical approach certainly improves the safety and reproducibility of single incision laparoscopic cholecystectomy.”

A video detailing the standardization methodology that will be presented at the American College of Surgeons in October 2012 at their annual meeting in Chicago.

Group includes:

Sharona B. Ross MD	Florida Hospital Tampa
Alexander S. Rosemurgy MD	Florida Hospital Tampa
Michael Albrink MD	University of South Florida
Giovanni Dapri MD	Saint-Pierre University Hospital
Scott Gallagher MD	Forsyth Medical Center
Santiago Horgan MD	University of California, San Diego School of Medicine
William Kelley MD	Richmond Surgical Specialist Group
Michael Kia DO	McLaren-Flint Regional Medical Center
Jeffrey Marks MD	University Hospital Case Medical Center
Jose Martinez MD	University of Miami Miller School of Medicine
Yoav Mintz MD	Hadassah-Hebrew University Medical Center
Dmitry Oleynikov MD	University of Nebraska Medical Center
Aurora Pryor MD	Stony Brook School of Medicine
David Rattner MD	Harvard Medical School
Homero Rivas MD	Stanford University School of Medicine
Kurt Roberts MD	Yale University School of Medicine
Eugene Rubach MD	Saint Francis Hospital
Steven Schwaitzberg MD	Harvard Medical School
Lee Swanstrom MD	Providence Portland Medical Center
John F. Sweeney MD	Emory University School of Medicine
Erik B Wilson MD	The University of Texas Houston Medical School
Harry Zemon MD	Hofstra North Shore-LIJ School of Medicine
Natan Zundel MD	Florida International University College of Medicine